JOURNALS / PUBLICATIONS
Journal
of Bihar Orthopaedic Association
Vol . XXI
No. 2 Feb.’07
EDITORS PAGE
COMPREHENSIVE ORTHOPAEDIC EDUCATION
A country, a house and a cell has a boundary. What about the
medical speciality ?
Development of super speciality are making our vision tubular.
Tubular vision is a focused vision but leaves much outside its purview – making
it narrow incomplete and incomprehensive.
Tubular vision gives an enlarged view with marginal aberration.
Orthopaedic surgery has quickly reached to unmanageable
dimension. It is heading for division; creation of new speciality with focused
vision. Some part has already been separated like PMR, others are in different
stages – Hand and Microsurgery, Foot, Spine, Replacement surgery, Traumatology
etc. The boundaries are blurred and intermingling. There remains junctional
areas.
Junctional areas will remain a problem unless……….
Now focus on what an orthopaedician prescribe.
Apart from conservative / operative line of management, a general orthopaedic
prescription will consist of
1. Radiological investigation
2. Pathological tests
3. Analgesic / Anti inflammatory drug
4. Anti microbial (s)
5. Other pharma products
6. Rehabilitation aids / management
7. With increasing age and other factors – we have to work with associated
problems of diabetes, hypertension; leave alone cardiac and renal problems.
All the medical sphere are advancing with the speed of expanding
universe.
How to cope with ………. ?
You need not enter into other sphere – you are lost in your own
only, but definitely you need to know the molecules, you are prescribing
(fortunately they are not as much as medicine people have to deal with).
You have to know the specificity , accuracy , false positive and
false negative results of pathological test you prescribe, other wise you end up
with the final report “kindly correlate clinically”.
Of course, an orthotic engineer will prepare an orthosis or
splints and occupational therapist, physiotherapist, clinical psyclologist will
assist the patient in the final outcome but you have defined the requirements
and verify whether the particular thing suits the need of the patients and your
purpose.
Above all you have to know what is available to you and your
patients.
Honest retrospection will show that our knowledge and updating of
pharma products is done by medical representatives claiming superiority of brand
names what of their molecular product. Comprehensive product monographs are
simply kept aside – you just can’t cope.
How do a practicing orthopaedic surgeon come to know about new
diagnostic, pathological test their real utility and dependability ?
Our most dependable friend, radiologists are taking us to new
heights. Very kindly they provide reports and also the supprt, x-ray plate,
plates of the scan, ultrasound, MRI etc. They see many things during scanning
and in between the plates, cuts and figures. They report their point of view.
What for they provide the support? Therefore, you have to see for yourself and
the very old saying `Eyes do not see what the mind does not know’ applies.
Should our relevant knowledge (deficiency/ need) not be updated
by our learned colleagues, master of their fields like physicians and
pharmacologist about few molecules and new molecules we prescribe, learned
pathologist about few and newer tests which will help us and physiatrists (PMR
people) who can educate us about what new products are available to salvages us
from salvaging unsalvageable limbs, and other rehabilitative measures which can
finally habitate our patients and us?
This is only possible by comprehensive education and focusing on
our interacting boundaries, upon which our survival depends.
With this orientation and view the present issue of the journal
of Bihar Orthopaedic Association is focused on Orthopaedic Radiology (beside the
facts that no body has listened to my earlier appeal. “ Your joy is everybody
joy” in previous journal vol XIII No.1 Nov, 2000.
Wish you a very happy new year ! (without much accidents and pain
to the masses).
Dr. V.K.Sinha
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